Predictors of Poor Hospital Discharge Outcome in Acute Stroke Due To Atrial Fibrillation

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Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: CE Test: Online Only Source Type: research

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A comparison of left atrial appendage closure and direct oral anticoagulants for stroke prevention in atrial fibrillation exposes the holes in noninferiority trial design, writes John Mandrola, on Medscape
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Cardiology Expert Column Source Type: news
Authors: Gunawardene MA, Hartmann J, Jularic M, Eickholt C, Gessler N, Willems S Abstract Atrial fibrillation (AF) is the most frequent persistent cardiac arrhythmia and is associated with an increased mortality. Therefore, an effective differential treatment of patients is mandatory. After a risk stratification oral anticoagulation (OAC) should be initiated depending on the individual stroke risk of each patient. Alternatively, in the presence of contraindications for OAC and an increased risk for bleeding and/or stroke, the implantation of a left atrial appendage closure device can be considered. Symptomatic pati...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Authors: Deltour S, Pautas E Abstract Primary and secondary prevention of stroke is often a challenge in elderly patients due to the increase in both thrombotic and hemorrhagic risks with age. In some cases, there is sufficient data in the elderly population to allow recommendations or anticoagulation decisions to be made, such as for the indication of anticoagulation to prevent stroke related to atrial fibrillation (AF) or the choice of oral anticoagulant therapy in this situation. In other situations, the less robust data leave some questions; this is the case for the delay to initiate an oral anticoagulant thera...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
ConclusionsIn this prospective experience in unselected patients with atrial fibrillation, persistence to apixaban was high, and efficacy and safety were comparable to the results in clinical trials, supporting its use in clinical practice.
Source: Cardiology and Therapy - Category: Cardiology Source Type: research
In this paper, the authors (Poole et al J Am Coll Cardiol. 2020;75:3105-3118. PMID 32586583) provide expanded results of an important secondary endpoint of the CABANA (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial, the recurrence of atrial fibrillation (AF). In the CABANA trial, 2204 patients with symptomatic AF and risk factors for stroke were randomized to catheter ablation or drug therapy with a primary endpoint was a composite of death, stroke, major bleeding or cardiac arrest during 5 years of follow-up.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
Heart Failure in Atrial Fibrillation - An Update on Clinical and Echocardiographic Implications. Circ J. 2020 Jul 08;: Authors: Taniguchi N, Miyasaka Y, Suwa Y, Harada S, Nakai E, Shiojima I Abstract Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and has unfavorable consequences such as stroke, heart failure (HF), and death. HF is the most common adverse event following AF and the leading cause of death. Therefore, identifying the association between AF and HF is important to establish risk stratification for HF in AF. Recent studies suggested that left atrial and ventric...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
rd A Abstract Using nationwide Danish registries, we conducted a population-based case-crossover study evaluating the association between switching from a vitamin K antagonist (VKA) to a direct oral anticoagulant (DOAC), and vice-versa, and 30-day risks of bleeding and arterial thromboembolism in atrial fibrillation (AF) patients. The case-crossover population was identified among oral anticoagulant users during 2011-2018 (n = 123,217), as AF patients with (a) a case-defining outcome and (b) an anticoagulant switch during the 180 days preceding the outcome. Odds Ratios were estimated using conditional lo...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
Abstract A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between drea...
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
Conclusion: To our knowledge, this case is the second report of a left atrial posterior wall thrombus in this setting. The patient's complex and specific set of risk factors likely led to this rare finding. Although left atrial posterior wall thrombus after ablation is rare, in patients with specific risks or a combination of factors that could lead to such a clot, visualizing the left atrium in these patients may be beneficial to minimize the risk of systemic embolization. PMID: 32612478 [PubMed]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
AbstractPurposeTo report on the clinical utility of implantable loop recorders (ILRs) in a large academic hospital setting over a 4-year period.MethodsRetrospective study (2013 –2016) of patients receiving ILRs for any indication including syncope, cryptogenic stroke (CrS), atrial fibrillation (AF) burden, palpitations, ventricular arrhythmias (VA), and other. Remote checks, symptomatic transmissions, and in-person checks were reviewed. Time to diagnosis was documented.ResultsA total of 263 patients (54% male, mean age 63  ± 15 years, mean follow-up 601 (range 9–1714) days) received IL...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
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